癌胚抗原和C-反应蛋白联合检测在良恶性胸腔积液鉴别诊断中的意义

目的探讨肿瘤标记物癌胚抗原(CEA)和C反-应蛋白(CRP)联合检测在良、恶性胸腔积液鉴别诊断中的临床意义。方法采用免疫放射法分别检测23例恶性胸腔积液(恶性组)和35例良性胸腔积液患者(良性组)胸水样本中CEA含量和CRP水平,并进行对比分析。结果恶性组患者胸水样本中CEA含量明显高于良性组(P<0.05),CRP水平明显低于良性组,差异有统计学意义(P<0.001),采用胸水中CEA含量及CRP联合检测诊断良、恶性胸腔积液的灵敏度、特异性和准确率分别为65.7%、70%和67.2%。结论联合检测胸腔积液中CEA和CRP水平在良、恶性胸腔积液鉴别诊断中具有重要的临床价值。     

端粒酶及端粒酶逆转录酶在良、恶性胸腔积液中的表达及意义

目的 研究端粒酶及端粒酶逆转录酶(hTERT)在良、恶性胸腔积液中的表达,为临床诊断提供实验依据.方法 选择21例恶性胸腔积液(恶性组)及23例良性胸腔积液患者(良性组),应用重复序列扩增法-ELISA(TRAP-EUSA)法及免疫组化方法检测积液中端粒酶、hTERT及癌胚抗原(CEA)表达.结果 良性组和恶性组端粒酶表达阳性率分别为39.13%、76.19%,P<0.01;hTERT表达阳性率分别为0、80.95%,P<0.01.hTERT检测恶性胸腔积液的特异度(100%)显著高于端粒酶(60.87%),敏感度(80.95%)显著高于CEA(47.62%).结论 hTERT检测恶性胸腔积液的敏感度和特异度均较高,且其免疫组化检测方法简便易行,值得临床借鉴.     

CEA及NGAL在恶性胸腔积液患者胸水中的表达及临床意义

目的探讨癌胚抗原(CEA)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在恶性胸腔积液(MPE)患者胸水中的表达及临床意义。方法回顾性分析2017年12月~2020年01月医院收治的93例MPE患者及107例良性组胸腔积液患者的临床资料,检测并比较两组患者胸水及血清中的CEA、NGAL表达水平,并采用受试者工作曲线(ROC曲线)分析胸水中的CEA、NGAL表达水平对良恶性胸腔积液鉴别诊断及对预后的评估价值。结果两组患者胸水、血清中的CEA表达水平比较,差异具有统计学意义(P0.05),且胸水中的CEA表达水平明显高于血清中表达水平,差异具有统计学意义(P0.05);两组患者胸水、血清中的NGAL表达水平比较,差异具有统计学意义(P0.05),且胸水中的NGAL表达水平明显高于血清中表达水平,差异具有统计学意义(P0.05)。ROC曲线显示,胸水、血清中的CEA、NGAL表达水平对鉴别诊断胸腔积液良恶性及患者预后评估具有一定的价值,且联合检测的价值更高。结论 CEA、NGAL在恶性胸腔积液患者胸水中呈高水平表达,联合检测CEA、NGAL可作为恶性胸腔积液鉴别诊断及患者预后评估的手段之一。     

葡萄糖转运蛋白1在恶性胸腔积液的表达及意义

目的评价葡萄糖转运蛋白l(GLUT-1)在恶性胸腔积液中的诊断价值。方法采用免疫细胞化学SP法检测肿瘤性和非肿瘤性胸腔积液中脱落细胞GLUT-1的表达以及ELISA法测定胸水中GLUT-1的水平。结果两组胸液脱落细胞GLUT-1的表达率恶性组为89.33%,良性组为3.17%,两组间具有统计学差异(P0.01);两组胸液上清中GLUT-1的表达水平恶性组为(1.18±0.35)pg/ml,良性组为(0.85±0.24)pg/ml,两组间具有统计学差异(P0.05)。结论 GLUT-1对恶性胸腔积液的诊断具有较高的敏感度,可以作为鉴别恶性胸腔积液的可靠标记之一。     

Tenascin-c和癌胚抗原检测在恶性胸腔积液中的诊断价值

目的探讨肌腱蛋白C(Tenascin C,Tn-C)和癌胚抗原(CEA)联合检测在肺癌所致胸腔积液中的表达及其临床意义。方法采用酶联免疫吸附(ELISA)法及电化学发光法分别检测60例肺部良性疾病所致胸腔积液和60例恶性胸腔积液中Tn-C和癌胚抗原(CEA)的表达,分析Tn-C蛋白的表达与临床特征及肺癌诊断的关系。结果恶性组患者胸腔积液中Tn-C的表达水平高于对照组(P0.05),Tn-C在胸水中的表达与患者的性别、吸烟状况、肿瘤大小、病理分期及病理分型无关(P0.05),与淋巴结的转移有关(P0.05);两组患者的Tn-C血清浓度无统计学差异(P0.05)。根据ROC曲线,以Tn-C浓度为41.508ng/ml为最佳诊断临界点,此点所对应的诊断恶性胸腔积液(MPE)敏感性为90%,特异度为46.67%,联合CEA诊断的灵敏度为80%,特异度为98.3%。结论 Tn-C在肺癌所致恶性胸腔积液中的表达水平较高,与CEA联合检测可提高恶性胸腔积液的诊断灵敏度及特异度,故Tn-C可作为肺癌诊断的良好标记物。     

AMPK信号通路在中老年肺癌患者恶性质胸腔积液中表达及临床意义

目的 研究腺苷酸活化蛋白激酶(AMPK)信号通路在中老年肺癌患者胸腔积液中的表达,从分子水平探明其在良、恶性胸腔积液中的影响。方法 以中老年肺癌患者胸腔积液为研究对象,其中恶性胸水78例,良性胸水42例;将良性胸水作为良性组,恶性(腺癌)胸水为恶性组,分别抽提两组细胞总RNA与总蛋白,RT-PCR检测肝激酶(LK)B1、AMPKα1和AMPKα2 mRNA表达情况,Western印迹检测LKB1、AMPKα1、AMPKα2和P-AMPKα蛋白表达情况。结果 与良性组比较,恶性组LKB1、AMPKα1、AMPKα2 mRNA表达明显下降(P<0.05,P<0.01);与良性组比较,恶性组LKB1蛋白表达降低(P<0.001);AMPKα1、AMPKα2蛋白表达有所降低,但差异无统计学意义(P>0.05);p-AMPKα水平表达差异有统计学意义(P<0.05)。结论 AMPK信号通路对鉴别良、恶性胸腔积液具有一定的临床提示价值。     

Napsin A在恶性胸腔积液中的表达及临床意义

目的 探讨天冬氨酸蛋白酶A(Napsin A)在恶性胸腔积液中的表达及临床意义.方法 采用免疫组化EnVision两步法检测Napsin A在105例临床胸腔积液标本中的表达,并分析其与临床病理学指标的关系.结果 napsin A在原发性肺癌患者胸水中的阳性率为79.2 (61/77),而在转移性肺癌患者和肺良性疾病患者的胸水中未见阳性表达,其检测原发性肺腺癌患者的胸水的灵敏度为85.3%,特异度为89.3%.结论 napsin A对原发性、转移性肺癌患者胸水中癌细胞的诊断及鉴别诊断具有重要的临床应用价值.     

肺癌患者胸水CD40、MMP-12水平的检测及临床意义

目的探讨肺癌患者胸水中CD40、MMP-12水平的测定及临床意义。方法选取60例胸水患者,其中30例为肺癌伴恶性胸腔积液,30例为良性胸腔积液。采用酶联免疫吸附法(ELISA)检测两组患者胸水CD40、MMP-12水平。结果肺癌患者胸水CD40、MMP-12水平均明显高于良性胸水(P0.05);不同病理类型肺癌患者胸水CD40、MMP-12含量(P0.05)无显著差异;联合检测胸水CD40、MMP-12水平诊断效能较好。结论肺癌患者胸水CD40、MMP-12含量高于良性胸水,对良恶性胸水患者具有鉴别诊断意义。     

联合检测胸液端粒酶、CEA、ADA对恶性和结核性胸腔积液的诊断价值

目的探讨端粒酶、癌胚抗原、腺苷脱氨酶联合检测对恶性和结核性胸腔积液的鉴别诊断价值。方法选择恶性胸腔积液31例,结核性胸腔积液35例,采用聚合酶联反应-酶联免疫吸附分析法(PCR-ELISA)检测胸腔积液端粒酶活性,用酶免疫分析法(EIA)检测胸腔积液CEA水平,用比色分析法检测胸腔积液ADA含量,并对测定结果进行统计学处理。结果端粒酶活性测定诊断恶性胸腔积液的灵敏度为0.870,特异度为0.943。CEA诊断恶性胸腔积液的灵敏度为0.744,特异度为0.886。ADA诊断恶性胸腔积液的灵敏度为0.967,特异度为0.971,正确性为0.969。结论端粒酶活性的测定,在良恶性胸水的鉴别诊断中具有重要价值,但存在假阴性和假阳性,若与胸水CEA、ADA联合检测,对良恶性胸水的鉴别诊断意义更大。     

联合检测血清和胸腔积液Crk样蛋白、CEA在恶性胸腔积液诊断中的价值

目的评价联合检测血清和胸腔积液中Crk样蛋白(CRKL)、癌胚抗原(CEA)对恶性胸腔积液的诊断价值。方法采用酶联免疫吸附法(ELISA)检测47例恶性胸腔积液和46例良性胸腔积液患者的血清和胸腔积液CRKL、CEA水平。结果恶性胸腔积液组血清CRKL显著高于良性胸腔积液组(P0.001),恶性胸腔积液组胸腔积液CRKL浓度显著高于良性胸腔积液组(P0.001);恶性胸腔积液组血清CEA显著高于良性胸腔积液组(P0.001),恶性胸腔积液组胸腔积液CEA浓度显著高于良性胸腔积液组(P0.001)。ROC曲线分析得血清及胸腔积液CRKL临界值分别为2.04ng/mL、3.04ng/mL,其敏感度分别为80.9%、74.5%;特异性分别为80.4%、84.8%。联合检测血清及胸腔积液CRKL的灵敏度为80.9%,特异性为80.4%;联合检测胸腔积液CRKL及CEA的灵敏度为89.4%,特异性为95.7%;联合检测四者的灵敏度为87.2%,特异性为97.8%。结论血清和胸腔积液中CRKL可作为鉴定良恶性疾病的重要辅助指标;胸腔积液CRKL联合胸腔积液CEA检测可提高恶性胸腔积液的诊断价值。     

肺癌组织的端粒酶活性表达及意义

应用ＰＣＲ－端粒重复序列扩增法（ＴＲＡＰ）检测３１例肺癌、４例癌旁及２６例肺良性肿瘤患者肿瘤组织的端粒酶活性表达。结果显示，肺癌组织中端粒酶活性表达率为８０．６％（２５／３１）、癌旁组织无表达、肺良性肿瘤组织表达率为７．７％（２／２６）。端粒酶活性表达与肺癌分化程度呈负相关，与肺癌分期无关。有及无淋巴结转移者的端粒酶活性表达率有显著性差异。提示端粒酶在肺癌的发生、发展及转移过程中皆起重要作用；其在肺癌组织中的高表达有望成为肺癌诊断、鉴别诊断的一项强有力的生物学指标。     

CEA、CYFRA 21-1对肺非小细胞性恶性胸腔积液诊断价值的研究

目的观察胸水及血清CEA、CYFRA21—1测定值对非小细胞性恶性胸腔积液的诊断价值。方法测定本院145例胸腔积液病人的血清及胸水CEA、CYFRA21—1,按良恶性分为两组,并行统计分析。结果胸水及血清CEA、CYFRA21-1测定值,在两组之间有非常显著差异。结论血及胸水肿瘤标记物测定可作为胸腔积液病人检测的一个常规项目,对恶性胸腔积液有较高的诊断价值。     

Expression of telomerase activity and oxidative stress in human hepatocellular carcinoma with cirrhosis

AIM: To study the expression and significance of telomerase activity and oxidative stress in hepatocellular carcinoma (HCC) with cirrhosis. METHODS: In this study, TRAP-ELISA assay was used to determine telomerase activity in 21 cases of HCC as well as in 23 cases of hepatic cirrhosis. Malondialdehyde (MDA), glutathione S-transferase (GST) and total anti-oxidative capacity (T-AOC) were also examined in the same samples with human MDA, GST and T-AOC kits. RESULTS: Eighteen of 21 cases of HCC were found to have increased telomerase activity, whereas only three of the 23 non-cancerous cirrhotic samples were found to have weak telomerase activity, and the difference was significant (P<0.001). No significant difference in telomerase activity was detected according to different tumor size, tumor stage, histological grade, HBsAg, contents of albumin, bilirubin, ALT, AFP, r-GT and platelet. There were significant differences between HCC and cirrhosis in the expression of MDA, GST and T-AOC respectively. Telomerase activity correlated positively with the content of MDA (P<0.05). CONCLUSION: Telomerase activation is the early event of carcinogenesis, which is not correlated with clinicopathological factors of HCC. The dysfunction of the anti-oxidative system is closely correlated with the progression from cirrhosis to hepatocellular carcinoma. Oxidative stress may contribute partly to telomerase activation.     

hTERT、Sp1、c-myc在良恶性胰岛β细胞瘤中的表达差异

目的检测人端粒酶逆转录酶(hTERT)、刺激蛋白1(Sp1)和原癌基因转录因子(c-myc)在良、恶性胰岛β细胞瘤和正常胰岛β细胞组织中的表达,探讨三者与胰岛β细胞瘤的关系,为临床鉴别良、恶性胰岛β细胞瘤和判断预后提供理论依据。方法用免疫组化方法检测hTERT、Sp1、c-myc在27例良性、16例恶性胰岛β细胞瘤和20例正常胰岛β细胞组织中的表达,并行相关性分析。结果 hTERT、Sp1、c-myc在恶性胰岛β细胞瘤中的阳性表达率分别为81.2%、75.0%、87.5%,在良性胰岛β细胞瘤中的阳性表达率分别为25.9%、29.6%、14.8%,在正常胰岛β细胞组织中没有表达。hTERT、Sp1和c-myc在良、恶性胰岛β细胞瘤的表达差异均有统计学意义(P均<0.05),且在恶性胰岛β细胞瘤的表达明显高于良性胰岛β细胞瘤和正常胰岛β细胞组织;hTERT与Sp1、c-myc的表达呈明显正相关(r分别为0.992、0.893,P均<0.01)。结论端粒酶的激活在良、恶性胰岛β细胞瘤的发生发展中起重要作用。联合检测hTERT、Sp1和c-myc的表达可作为鉴别良、恶性胰岛β细胞瘤的手段。     

Expression profile of the telomeric complex discriminates between benign and malignant pheochromocytoma

Telomerase, a ribonucleoprotein complex that includes the telomerase RNA component, the telomerase-associated protein (TP1), the telomerase catalytic subunit (hTERT), and the heat shock protein 90 (HSP90), is closely related to the malignant potential of human tumors. In pheochromocytomas (PC) it is very difficult to predict malignant potential by conventional histology or immunohistochemical and molecular markers. To test whether the expression of telomerase subunits is reflected in the malignant transition of PCs, we determined their mRNA and/or protein expression in 28 benign and nine malignant PCs and compared the results with telomerase activity. RT-PCR analysis revealed that TP1 was ubiquitously expressed. The telomerase RNA component was found in all malignant (100%) and in 13 of 28 (46%) benign PCs. In contrast, hTERT was clearly associated with aggressive biological behavior. All of the malignant (100%), but only two of 28 benign (7%) PCs expressed hTERT. HSP90 was increased in malignant PCs, but was also expressed at a lower level in benign tumors. High telomerase activity was measurable in hTERT-positive tissues only. Our data indicate that hTERT, HSP90, and telomerase activity are up-regulated in malignant cells of the adrenal medulla. The common expression of hTERT and telomerase activity thus represents an additional prognostic marker that may identify more aggressive tumors.     

端粒酶检测在良恶性腹水鉴别诊断中的价值

目的探讨脱落细胞中端粒酶活性在良恶性腹水鉴别诊断中的价值。方法应用端粒酶TRAP-PCR-ELISA法分别检测60例腹水患者脱落细胞中的端粒酶活性,并与细胞学及相关肿瘤标志物进行对比分析。结果恶性腹水中的端粒酶活性水平明显高于良性腹水,在良性腹水中端粒酶活性的阳性率为10%,明显低于恶性腹水中端粒酶活性的阳性率90%,同时恶性腹水中端粒酶活性的阳性率同脱落细胞病理学检查、腹水综合指标测定(癌胚抗原、甲胎蛋白等)以及乳酸脱氢酶腹水/血清检测结果相比较,差异亦具有显著性(P<0·01)。结论脱落细胞中端粒酶活性检测可作为良恶性腹水的鉴别诊断标志。     

Real-time quantitative PCR of telomerase mRNA is useful for the differentiation of benign and malignant pancreatic disorders

The presence of telomerase activity has been proposed as a specific and sensitive marker for malignant tissue, and positivity rates of up to 95% have been reported in pancreatic cancer. In the present study telomerase activity analysis was reevaluated in 29 pancreatic cancer tissues compared with 36 chronic pancreatitis tissues and 21 normal controls, and a study was made of whether malignant and benign pancreatic disorders can be better differentiated using a novel technique real-time quantitative PCR analysis-analyzing telomerase mRNA expression. Telomerase activity was present in 35% (10 of 29) of pancreatic cancer samples, 3% (one of 36) of chronic pancreatitis samples, and none of the normal pancreatic tissue samples in the TRAP assay. Real-time quantitative PCR analysis revealed the presence of telomerase mRNA expression in 50% (10 of 20) of normal, 86% (31 of 36) of chronic pancreatitis, and 90% (26 of 29) of pancreatic cancer samples. However, quantification of the expression data revealed that the relative increase above normal was 5.5 (range, 3.5-8.6) for chronic pancreatitis and 23.9 (range, 18.6-30.7) for pancreatic cancer samples (p < 0.01). No relationship was found between telomerase activity and the fold increase of telomerase mRNA above normal and gender, patient age, tumor stage, or tumor grade. These data indicate that detection of telomerase activity using the TRAP assay has limitations in differentiating benign and malignant pancreatic disorders. However, telomerase mRNA analysis by real-time quantitative PCR analysis allows a highly sensitive detection and differentiation of pancreatic cancer from normal pancreas and chronic pancreatitis and thereby may serve as a new reliable, easy, and effective diagnostic tool for cancer diagnosis.     

Telomerase activity correlates with cell cycle regulators in human hepatocellular carcinoma

AIMS/BACKGROUND: Mutation in cell cycle genes is the most common genetic change in malignant tumor cells. Telomerase activation, considered as essential in the immortality of cancer cells, is found in most cancers, where there may be an association with an active cell cycle. METHODS: In this study study we used the TRAP assay to determine telomerase activity in liver tumor specimens from 25 cases of hepatocellular carcinoma (HCCs) as well as in corresponding non-cancerous liver tissue in each patient. The expression of cyclin D1, cdk2, and cdk4 protein was also examined by Western blot. RESULTS: Twenty-one of the 25 cases of HCC were found to have increased telomerase activity, whereas only five out of the 25 non-cancerous liver samples were found to have weak telomerase activity. Telomerase activity was not found to be related to tumor size, HBsAg, HBeAg, anti-HCV, transaminase, or alpha-fetoprotein serum titer. Furthermore, three out of the 25 cases of HCC showed cyclin D1 overexpression, whereas 15 of the 23 cases of HCC showed decreased cyclin D1 expression. Down regulation of cyclin D1, cdk2, cdk4 protein correlated with telomerase activity (p<0.004, p<0.013, and p<0.001 respectively). CONCLUSION: The results indicate that genetic defects in HCC facilitate the reactivation of telomerase activity, a process which may be dependent on cyclin D1 with its cyclin dependent kinase (cdk) partner defect.     

胸腔积液中白细胞对端粒酶活性影响的分析

目的通过免疫磁珠技术去除胸腔积液中的白细胞（WBC）后检测其中肿瘤细胞的端粒酶活性,探讨白细胞对胸腔积液肿瘤细胞端粒酶活性的影响。方法收集15例患者胸腔积液,其中良性胸腔积液5例,恶性胸腔积液10例,应用TRAP—PCR—ELISA法检测分别经免疫磁珠阴性法及密度梯度离心法富集后胸腔积液细胞端粒酶活性。结果利用吸光度差值（△A）定性分析显示去除白细胞前后良恶性胸腔积液端粒酶活性无明显差异（P〉0．05）;利用患者胸腔积液肿瘤细胞相对端粒酶活性值（RTA）定量分析,10例恶性胸水经两种方法富集后的RTA值比较有差异（P〈0．05）,免疫磁珠阴性法富集后恶性胸水肿瘤细胞RTA明显高于密度梯度离心法富集后的恶性肿瘤细胞;5例良性胸水经两种方法富集后的RTA值之间比较无显著性差异（P〉0．05）。结论定量分析显示利用免疫磁珠阴性法富集胸腔积液肿瘤细胞后进行端粒酶活性检测去除了白细胞对肿瘤细胞端粒酶活性的影响,提高了检测的敏感性和特异性,可用于良恶性胸腔积液的鉴别。     

腔内注射干扰素治疗晚期恶性胸水与胸水中Th1/Th2的相关性

目的探讨腔内注射干扰素治疗晚期非小细胞肺癌患者恶性胸腔积液的疗效与胸水中Th1/Th2型细胞因子的关系。方法对晚期非小细胞肺癌合并恶性胸腔积液患者每周以干扰素500万单位行腔内注射,连续4周,评价其疗效。同时采用流式细胞术检测胸水中IL-2、IFN-γ、IL-4和IL-10水平,比较干扰素治疗有效组与无效组治疗前后各细胞因子的变化。结果干扰素治疗有效组IL-2和IFN-γ上升,IL-4和IL-10下降（P〈0.05）;无效组各细胞因子变化无统计学差异（P〉0.05）。结论晚期非小细胞肺癌患者恶性胸水中Th1细胞因子优势化是影响其治疗效果的主要因素之一。